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'Training more nurses is only answer to crisis'


The post-Francis emphasis on adequate numbers of nurses to provide safe care has been a good thing, as we’ve often said in this magazine.

However, the scramble to employ enough nurses to achieve safe staff levels and skill mix has been a challenge for many trusts.

To achieve numbers that look healthy enough to publish on the NHS Choices website, trusts from across the UK are relying on huge increases in the use of expensive agency staff (page 4) or recruiting from overseas (page 2) because there simply aren’t enough homegrown nurses to meet demand.

To those of you who have been in nursing a while, this sort of boom and bust cycle is familiar. Yet many nursing shortages are entirely predictable. For example, the fact that huge numbers of nurses are approaching retirement age is not new information, but university funding has not produced enough newly qualified nurses to replace them. As a result, directors of nursing and their deputies have had to dig out their passports and look abroad.

But is this strategy worth it? Our exclusive investigation reveals that a shockingly low proportion of migrant recruits stay with the trust that hired them - in some cases, trusts have retained none of the staff they recruited from overseas.

Our data only shows how many left their recruiting trust, but not why or where they went, so we don’t know whether they have stayed in the UK or with the NHS. However, one thing is clear: it is extremely expensive for trusts to hire overseas, and damaging to NHS finances if these recruits don’t stay long enough to provide a return on that investment. And this is only part of the problem.

A report published last week by the Royal College of Nursing calculated that NHS spending on agency staff totalled almost £1bn. Agency nurses can provide flexibility to meet fluctuating needs in the short term. But spending £980m - which the RCN says would pay for 28,155 permanent staff - seems shortsighted.

The over-reliance on international and agency staff points to one thing: we didn’t train enough nurses. We’ve been commissioning training places on the basis of affordability, not demand.

Nursing has always been an easy target for short-term cuts to balance the books. That has to stop. The Department of Health and NHS England’s strategies won’t work without nurses to deliver them.

Jenni Middleton, editor

Follow me on Twitter @nursingtimesed


Readers' comments (5)

  • Training more nurses is not the ONLY answer, that is both naive and foolish. Nurses do not work in isolation and are not the answer to everything. For high quality patient care you need a team of doctors, nurses, therapists, social workers and support workers. To constantly call for more nurses at the expense of other professional groups is dangerous and puts the nursing profession on an advasarial course with colleagues we must be united with in multi professional teams responding to patient need. Yes - we need more nurses, but let's be sensible and hear the call for increased multi professional, multi agency teams that are focussed on meeting patient need.

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  • I think rather than just increase training numbers an entire honest workforce debate should be had. The number of student nurses who leave the course is currently very high, why? The number of qualified nurses who are leaving the NHS is very high, why? Until we understand the answers we will never be able to come up with a solution that will work. The number of nurses who are due to retire is also alarmingly high and I am not sure an increase of 22% will cover even natural wastage. Until we value the contribution that nurses make we will not recruit the right people in the first place. Unfortunately this is a very simplistic answer to a complex problem that is a direct result of 15 years + of ineffective workforce planning and staff engagement.

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  • Where have all the Agency nurses come from?

    And why are they working agency?

    Are they nurses who have left the NHS because of conditions of employment, inflexibility of hours, downgrading , no increase in salary, bullying etc so that they prefer to be independent and able to work to fit in with family commitments and work when they want to work,

    Or are they nurses working frantically to make enough money to fill the deficit in they salary ?

    maybe we have to think of new styles of employment ! just one idea,

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  • Cannot speak for all, but a number of agency nurses are lucky enough to have retired. Stepping down is an option from 50 onwards. Nursing work is physically demanding for the over 50s, obvious example being 12 and a half hour shifts on a 30 or 32 bedded ward with minimal staffing levels and high dependency of patients.

    It has been known for many years that large numbers of nurses would be retiring in this decade and yet numbers of nurses in training was reduced.

    I meet many young people who have failed to get places at university to study nursing and yet in my opinion (based on 38 years as an NHS nurse) would make perfectly good nurses.

    The answer for successive governments is to rob third world countries of educated people to care for our own population.

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  • In my opinion making nurse training degree only is a mistake. This risks putting off mature students (I've seen very few in the last few years), so we lose out on valuable life experienced staff. There is much more to nursing that academia, such as common sense, a strong work ethic, confidence, and a sense of what is right and wrong.

    Wards are very very busy and sometimes hostile environments, it takes the right kind of person to cope with this, I see a lot of young young nurses struggle.

    People with natural skills in communication and management which often comes with maturity are missing from the work place as is diversity of age.

    You don't need a degree for nursing, if you find you want one you can study for one later when your qualified.

    So train more nurses but somehow, make nursing attractive to mature students.

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